Misleadership The Liberal Party of Australia hates Medicare. They hate it purely on the basis that it was introduced by the Australian Labor Party and has been a great, transformative success; and that it is a benefit to the poor. Opposition to Labor is ingrained in this mob. They preference the big end of town on the basis that it from this source that they derive their legitimacy. Therefore any success by Labor must be rolled back. That Medicare has been so successful and so popular presents a challenge to them, however, so they must be duplicitous in how they reverse the program. Deep-seated resentment of the poor in a philosophical matter: like puritanical conservatives of the American Republican party, they believe the poor deserve their condition, that it is a moral failing. This extends to the elderly and sick. Wealth and good health are the rewards of providence for virtue and the evidence of it. So when the current Minister for Health, Sussan Ley, announces a review of Medicare, this would be a welcome development, from any other set of politicians. The review will include all procedures, tests and treatments, on the basis that there is a need to reduce “inappropriate tests and procedures”, because, primarily, many are no longer used. Of course, a test, treatment, or procedure that is no longer used isn’t costing anything, but that’s not the point. The point is to simply to stop spending money on health care. The review will also examine new ways of paying GPs, which is fine, potentially working towards a better system of managed care, to reduce the need for more complex procedures and interventions such as now inevitably arise from the lack of management of conditions such as obesity, diabetes, heart disease, etc. Early intervention and management over the longer term means fewer people needing emergency and more costly interventions later. This, of course, costs money now, but reduces spending overall. Don’t expect this to be an outcome of the review. Instead, expect GP care to become part of private medical insurance coverage, shifting the cost from Medicare to the consumer and killing off bulk-billing as effectively as the previously mooted co-pay and rebate reductions. New rules are expected to be implemented to address the issue of Medicare cheats. But it’s actually doctors rorting the system more so than it is patients, and you would be foolish to believe that’s going to be the focus of the review. Instead, the “Medicare cheating” to be addressed will be rules to make it more difficult for the poor and middle class to access Medicare on the basis they are accustomed to, requiring more out-of-pocket expenditures and a reduction in services. The Australian Medical Association and Consumers Health Forum may welcome the review, but they should be cautious in their embrace of it, like the farmer and the viper. We know who these Liberals are, and their nature.

Health Care & Aged Care Our illustrious Treasurer, Joe Hockey, is trying to sell the nation on the idea that we have to have a co-pay for visiting a doctor, or that the payments to doctors for short appointments needs to be reduced, because somewhere in the world today a child may be born who will live to 150 years of age. Of course, if he can't afford health care because, after he's paid his Medicare levy etc. he can't afford the co-pay, or doctors no longer bulk-bill so they can make up the shortfall imposed by government, he won't live so long and certainly not well. Hockey also relates the story of only having to pay $40 for the treatment of his son's broken foot. He says that was "inherently wrong", because he could afford to have paid more. No, Joe, that doesn't make it wrong. You - and the rest of us - pay the Medicare levy so that we can access health care. That's what it's for. We may need to raise the levy. The levy may only be raising half the annual cost. But there are other initiatives that can be taken and that would make sense to improve health care delivery and maintain access for everyone. You only need to read a newspaper to find out about them, or talk to actual health care professionals. It might mean more money spent now and less - significantly less - later, but it puts the program on a progressive track, taking advantage of new technologies, new techniques, new and better practices. But that's not what this government wants to do. At best their ideological commitment to "small government", something they never fail to fail to achieve, demonstrates a complete misapprehension that government is the one organisation that can apply the leverage needed to make things better. At worst it's simply that they hate Medicare. They hate the very idea of someone else getting something they think they're not getting - even when they are. Good Catholic boys who heard "the poor you will have with you always" and learned the wrong lesson from the story, they've somehow adopted the mindset that being poor or ill is a moral failing. Joe Hockey, Tony Abbott, our current and former health ministers, they are lying. Medicare is not "unsustainable", and we do not need to inflict "price signals" on health care.

Paying for It The Liberals are abandoning their proposed $7 co-pay for doctor visits: good. It was a bad policy. The policy proposed adding this out-of-pocket tax to pay for a so-called “medical research future fund”, but the purpose was quite simply to drive people away from doctors, based on the claim that too many were going too often for too little. Are there people turning up at their bulk-billing physician’s office or clinic at the least sign of a sniffle or just because they’re lonely? Probably, but that doesn’t make Medicare “unsustainable”, as is so often claimed to be its status. In fact, Medicare is eminently sustainable, but health care itself does need work. I read a lot about various efforts being undertaken to improve health care delivery in the US and elsewhere. These may involve larger initial outlays, but the outcomes produced provide significant reductions in long-term costs well-beyond what’s spent at the beginning, and overall patient health is similarly improved. That’s big, as big, in its way, as antibiotics. It’s also smart, much smarter than driving people away from doctors or increasing the tax used to pay for health care. The supporters of the tax call it “structural reform”, but it isn’t a reform, unless you think abandoning universal health care is a reform, and it isn’t structural, as it doesn’t address health care itself. Pushing people away from health care is only going to make it more expensive as more people end up with worse health an earlier intervention could have prevented. Pushing health care into the private sector will not only increase costs, it will make it unavailable to the poor and burden the middle class, but that’s the idea, really. Liberals hate the poor. They regard poverty and illness as moral failings that should be punished. They despise the middle class for being aspirational and sucking up money that belongs to the wealthy. This is an ideological driver for the party and for the policies they seek to enact. That and the fact that Medicare was a successful Labor Party initiative for the last forty years, and nothing Labor has ever done can be tolerated. The Liberals have decided on a practice of extreme opposition, even in government, and this is one of the worst actions they’ve yet undertaken. Don’t count on the “co-pay” tax being gone forever. The Liberals are nothing if not persistent. Update: Absent the ability to put through their tax, the Liberals now propose to effectively stop paying doctors what they're owed for providing health care under Medicare. This is a despicable abrogation of their responsibility to the public and a slap in the face to doctors.

Believers Yesterday was the People's Climate Mobilisation, and around the world, people gathered to let their politicians know the time for action is now, not later. BBC coverage includes the gathering in Glebe, where we formed a "human sign": Beyond Coal & Gas". Now that China has reduced its imports of our brown coal, we can hope they will make further progress towards emissions reductions, but also that our Prime Denialist, Tony Abbott, will take renewable energy production seriously, regardless of whether Treasurer Joe Hockey finds wind turbines objectionable intrusions on his aesthetic sense while driving between Sydney and Canberra, or not. (What did we do to deserve these lunatics as our government?)

End of Life Planning So our Federal Treasurer thinks we should work until we die, because life ends at retirement. No, Mr. Hockey, you bullying creep, life does not end at 65 or 70 or at whatever age we retire. Work does not define life. The economy is not society. We are not your serfs. Who voted for these jackasses?